Investigation of New Therapy with Orthostatic Self-Training and Mechanisms for Neurocardiogenic Syncope

本研究的目的是探讨家庭立位自我训练对预防倾斜所致神经性心源性晕厥的疗效。46例有自发性晕厥并经直立倾斜试验(80度/30min)确诊的神经心源性晕厥患者纳入本研究。所有患者均接受单独的家庭立位自我训练30min，不接受任何药物治疗，并在4周内以相同的初始倾斜测试方案进行重新评估。重新评估的直立倾斜试验在家庭立位自我训练后未诱发晕厥。训练后心率变异性表现为直立位早期L/H比值较训练前显著降低。在平均11个月的长期随访中，所有患者均成功地接受了家庭立位自我训练，没有出现晕厥或晕厥前的症状。我们的结论是，家庭立位自我训练是预防倾斜性神经性心源性晕厥的一种非常有效、安全和有用的治疗选择。

The purpose of the present study was to investigate the efficacy of home orthostatic self-training program for the prevention of tilt-induced neurocardiogenic syncope. A total of 46 neurocardiogenic syncopal patients, who had experienced spontaneous syncope and were diagnosed by head-up tilt testing (80 degrees for 30 min), were included in the present study. All patients were treated with home orthostatic self-training alone for 30 minutes without any drug therapy and reevaluated within 4 weeks with the same protocol of initial tilt testing. Reevaluated head-up tilt testing could not induce the syncope after the home orthostatic self-training. Heart rate variability after the training showed significant decrease of L/H ratio at the early stage of upright position compared to that before training. All patients were successfully treated with home orthostatic self-training alone without any symptoms such as syncope or presyncope during the long-term follow-up of mean 11 months. We concluded that home orthostatic self-training is a very effective, safe and useful therapeutic option for the prevention of tilt-induced neurocardiogenic syncope.